The influence of psychiatric comorbidities and sexual trauma on lower urinary tract symptoms in female veterans.

Purpose: We characterized the association of psychiatric comorbidities and sexual trauma with lower urinary tract symptoms in women.

Materials And Methods: Consecutive women (121) referred for evaluation of lower urinary tract symptoms to a specialized urology clinic were given validated questionnaires including the Urogenital Distress Inventory-6 and Incontinence Impact Questionnaire-7. These data were then analyzed according to psychiatric comorbidities, history of sexual trauma, age, race and obstetric history. Baseline incidence of psychiatric comorbidity and sexual trauma was also compared to a control population (1,298) from which all patients were referred.

Results: Women referred for evaluation of lower urinary tract symptoms had higher rates of psychiatric comorbidities (64.5% vs 25.9%, p <0.001) and sexual trauma (49.6% vs 20.1%, p <0.001) compared to those in the primary care clinic. Total survey scores for the Incontinence Impact Questionnaire-7 were significantly higher for patients with psychiatric comorbidities and sexual trauma (11.05 +/- 0.84) compared to scores of patients with neither of these conditions (7.6 +/- 1.02, p = 0.010). Stepwise multivariate regression analyses demonstrated that higher Urogenital Distress Inventory-6 scores were associated only with age younger than 50 years and history of miscarriage, and that higher Incontinence Impact Questionnaire-7 scores were associated only with psychiatric comorbidities and history of miscarriage.

Conclusions: Psychiatric comorbidities and sexual trauma are prevalent in female veterans presenting for evaluation of lower urinary tract symptoms and psychiatric comorbidities are associated with greater quality of life impact.